The Buzz

February 5, 2014

STATE HOUSE: SC Medicaid has $384 million surplus

The Buzz

A blog from The State's political team of Cassie Cope, Jamie Self and Andy Shain. Email tips to

South Carolina's Medicaid program ended the 2013 fiscal year with a $384 million surplus, state director Tony Keck told lawmakers on Wednesday.

The surplus was a far cry from 2011, when the agency had a mid-year deficit of $228 million.

Keck said a variety of factors led to the surplus, including:

  • • More people on Medicaid are using generic drugs instead of name brand drugs
  • • Hospital inpatient discharges have decreased
  • • Electronic health record costs were lower than expected
  • • Medicare premium increases were less than expected

The surplus means the agency had $369 million in its reserve account.

"We use some of that (reserve money) to fund one time costs within the agency," Keck told lawmakers. "We don’t want that reserve to grow too big. There are other uses for it y’all have throughout the state."

South Carolina's Medicaid program provides health insurance for the poor and disabled. As of June 30, 2013, the program had more than 1 million people enrolled.

Democrats want South Carolina to expand its Medicaid program to cover more people, as allowed by the federal Affordable Care Act. But the state's Republican-controlled legislature has refused to expand the program, arguing it would cost the state too much money in the long run.

Despite that, South Carolina's Medicaid program is growing rapidly, records show . Medicaid applications in South Carolina increased 8.2 percent in December 2013 from the previous year, while January's applications were up 2.9 percent.

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